曲安奈德溶液联合西吡氯铵含片治疗轻中度糜烂型口腔扁平苔藓的临床疗效

Clinical efficacy of triamcinolone acetonide combined with cetylpyridinium chloride in treatment of mild to moderate erosive oral lichen planus

目的观察曲安奈德溶液联合西吡氯铵含片治疗轻中度糜烂型口腔扁平苔藓的临床疗效及安全性。方法对100例诊断为轻中度糜烂型口腔扁平苔藓的患者,采用局部涂擦曲安奈德溶液联合使用西吡氯铵含片(试验组,50例)或单纯使用曲安奈德溶液(对照组,50例)进行治疗。分别在治疗前、治疗2周后、治疗4周后评估并记录患者的视觉模拟评分法(VAS)评分、临床症状评分及安全性。结果重复测量资料方差分析显示VAS评分处理效应和时间效应的交互作用(F=1.680,P=0.382)以及处理效应(F=0.749,P=0.391)无统计学意义,时间效应(F=190.641,P<0.001)有统计学意义,治疗后2组VAS评分均呈逐渐降低趋势。临床症状评分处理效应和时间效应的交互作用无统计学意义(F=1.198,P=0.296),处理效应(F=4.758,P=0.034)和时间效应(F=268.249,P<0.001)均有统计学意义,治疗后试验组临床症状评分低于对照组,且均呈逐渐降低趋势。治疗4周后唾液真菌培养显示对照组白色念珠菌感染率(23.4%)高于试验组(6.1%),差异具有统计学意义(P=0.016)。结论在短期内曲安奈德溶液联合西吡氯铵含片治疗轻中度糜烂型口腔扁平苔藓具有明显的临床疗效和较好的安全性,西吡氯铵可能对真菌感染起到一定的预防作用。

Objective To observe the clinical efficacy and safety of triamcinolone acetonide solution combined with cipyrronium chloride tablets in the treatment of mild to moderate erosive oral lichen planus.Methods A total of 100 patients diagnosed with mild/moderate erosive oral lichen planus were treated with topical application of triamcinolone acetonide solution in combination with cipyrronium lozenges(test group)or triamcinolone acetonide solution alone(control group).VAS scores,clinical symptom scores and safety indicators were recorded before,2 weeks and 4 weeks after treatment.Results The analysis of variance of repeated measures data of the VAS scores showed that the interaction effect(F=1.680,P=0.382)and the main effect of treatment(F=0.749,P=0.391)were not statistically significant,and the time effect(F=190.641,P<0.001)was statistically significant.The VAS scores in two groups showed a decreasing tendency after corresponding treatment.The interaction between treatment effect and time effect of clinical symptom scores was not statistically significant(F=1.198,P=0.296),the main effect of treatment(F=4.758,P=0.034)and time effect(F=268.249,P<0.001)were statistically significant.After corresponding treatment,the clinical symptom score in the test group was lower than that in the control group,and both showed a gradual decrease after treatment.Salivary fungal culture at 4 weeks after treatment showed that the infection rate of Candida in the control group was significantly higher than that in the test group(23.4%vs.6.1%,P=0.016).Conclusions Application of triamcinolone acetonide solution combined with cipiromonium chloride tablets yields high short-term clinical efficacy and safety in the treatment of mild to moderate erosive oral lichen planus.Cipiromonium chloride may play a certain role in the prevention of fungal infection.